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Parkinsons disease lecture
"Parkinsons disease lecture in power-point format"
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Search for more information on this subjectParkinsons Disease Lecture outline in Simple Text Form:- Slide 2: Essay on the shaking palsy James Parkinson 1817 “involuntary tremulous motion,with lessened muscular power, in part not in action and even when supported ;with a propensity to bend the trunk forward, and to pass from a walking to a running pace , the senses and intellect being uninjured” AskTheNeurologist.Com Slide 3: Pathology Loss of pigmented cells in substantia nigra ) Intracellular cytoplasmic inclusion bodies ) Lewy bodies AskTheNeurologist.Com Slide 4: PD is characterised by loss of Dopaminergic cells in the substantia nigra leading to abnormal activity in the basal ganglia as a whole This leads to A decrease in the activity of the direct GABAergic pathway - An increase in the activity of the indirect GABAergic pathway - AskTheNeurologist.Com Slide 6: AskTheNeurologist.Com (PD lecture) Slide 7: Uptake of radio-labelled L-Dopa in striatum of normal compared to PD brain AskTheNeurologist.Com Slide 8: Clinical Features T Tremor R Rigidity A Akinesia / Bradykinesia P Postural instability AskTheNeurologist.Com Slide 9: Micrographia manifestation of bradykinesia = AskTheNeurologist.Com Slide 10: Parkinsons Disease Lecture Slide 11: Overview of drug treatment 1. L-Dopa ) bypass rate limiting stem of Dopamine synthesis) 2. Dopamine agonists ) direct effect on striatum ) 3. COMT inhibitors ) less peripheral inactivation of L-Dopa ) 4. Selegeline ) MAOb) inhibitor ? Neuroprotective 5. Muscarinic antagonists ) act on striatal interneurons) 6. Amantadine ) mechanism unclear ? Dopamine release ) AskTheNeurologist.Com Slide 12: Treatment strategies 1. The conservative approach 3. The neuroprotective approach 5. The symptomatic approach AskTheNeurologist.Com Slide 13: Conservative approach 1. Avoid all drugs until symptoms are troublesome 3. When symptoms become troublesome start amantadine and an anticholinergic 5. When symptoms become disabling introduce L-Dopa or agonists at minimal doses AskTheNeurologist.Com Slide 14: Neuroprotective approach 1. All newly diagnosed cases should be started on Selegeline 4. When symptoms become disabling add dopaminergic drugs AskTheNeurologist.Com Slide 15: Symptomatic approach At diagnosis treatment immediately started with dopaminergic drugs Treatment continually modified in order to maintain maximum function for the maximum amount of time AskTheNeurologist.Com Slide 16: Clinical fluctuations in PD Condition Management Wearing-off of L-Dopa effect Decrease between dose interval Sustained release L-Dopa Add DA agonist Increase dose Add COMT inhibitor Delayed onset of response Ensure L-Dopa not given with protein. Give antacids “ Off ” periods Increase dose of L-Dopa Increase dose frequency Give before meals On-Off phenomenon Very difficult to treat Sustained release preparations AskTheNeurologist.Com Slide 17: Dyskinesias in PD Type Management Peak-dose dyskinesia Decrease each dose of L-Dopa Add Dopamine agonist Add amantadine Myoclonus Clonazepam Decrease L-Dopa AskTheNeurologist.Com Slide 18: Psychosis in PD Increased incidence in - Elderly - Pre-existing psychiatric conditions Should only use atypical antipsychotic medications….in particular CLOZAPINE - needs monitoring of white cell count QUETIAPINE - no monitoring necessary - now possibly drug of choice AskTheNeurologist.Com Slide 19: The End AskTheNeurologist.Com Author Anon AskTheNeurologist.Com
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